Diagnostic utility of gray scale ultrasound and elastography in solitary thyroid nodules

Abstract

Background: An elevated risk of cancer is linked to a firm and hard thyroid nodule upon palpation. Palpation is a personal experience. Elastography was developed to objectively assess tissue hardness and improve gray-scale ultrasonography's (US) diagnostic precision.

Goals: To assess the diagnostic value of elastography and gray-scale ultrasonography (US) in distinguishing between benign and malignant thyroid nodules.

Materials and methods: Our Dhiraj General Hospital conducted a six-month retrospective examination of the Gray scale US and elastography of 70 solid thyroid nodules in 50 patients. Using a generalized estimating equation, the diagnostic performance of grayscale US, Elastography with Rago and Asteria criteria, and Odd's ratios (ORs) with 95% CIs for predicting thyroid cancer were compared with the gold standard FNAC.

Results: 70 solid thyroid nodules in 50 patients were evaluated. 21 were malignant and 49 were benign. Sensitivity, negative predictive value (NPV), and Odd’s ratio(OR) of gray-scale US for the 70 nodules were 91.6%, 94.5% and 22.2 respectively, and these values were higher than the 15.6% and 65.3% sensitivity, 71.6% and 79.2% NPV and 3.6 and 2.7 ORs found for elastography with Rago and Asteria criteria, respectively.

Conclusion: Elastography alone as well as the combination of elastography and gray-scale US showed inferior performance in the differentiation of malignant and benign thyroid nodules compared with gray-scale US features. Hence elastography is not a useful tool in recommending FNAC.